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Children and adolescents with chronic kidney disease (CKD) are at high risk for cardiovascular morbidity and mortality. This review provides a comprehensive overview of the possible risk factors for early atherosclerosis in children with CKD. Endothelial dysfunction, a precursor of atherosclerosis, starts early in renal disease, as indicated by increased carotid artery intima media thickness, carotid arterial wall stiffness, impaired flow mediated dilatation, and coronary artery calcification, which are frequently present in children with CKD. Many risk factors for atherosclerosis, such as hypertension, dyslipidemia, renal bone disease, hyperhomocysteinemia, and uremia-related cardiovascular risk factors are associated with CKD. All of these risk factors are modifiable and optimal clinical management can delay or prevent cardiovascular disease. Another strategy to decrease the risk of premature cardiac disease and death in children with CKD is to slow the progression of renal disease.

BackgroundAcute kidney injury (AKI) in critically ill children is associated with increased mortality and morbidity. In this study we evaluated the effect of AKI severity on the incidence of short-term mortality and morbidity.MethodsMulticenter prospective cohort study was conducted over two years period. We used the Kidney Disease Improving Global Outcomes (KDIGO) to diagnose and stage AKI.ResultsA total of 511 out of 1367 included children (37.4%; 95% CI: 34.8–40.0) were diagnosed with AKI. They were categorized into three KDIGO stages: stage I (mild) in 47.5% (95% CI: 43.2–52.0), stage II (moderate) in 32.8% (95% CI: 28.8–37.1) and stage III (severe) in 19.7% (95% CI: 16.4–23.5). Stage II and III AKI had higher risk of mortality and longer length of stay (LOS) in hospital.Children with stage III AKI were more likely to require mechanical ventilation, referral to pediatric nephrology and discharge with abnormal creatinine level (above 100 uml\L).Hypervolemia, hypocalcemia, anemia, and acidosis were found to be independent risk factors of mortality.ConclusionThe extent of severity of AKI is directly associated with increased mortality, LOS and short-term morbidity.

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To investigate the correlation between chronic kidney disease (CKD) and the development of neurological disease among pediatric patients in Saudi Arabia. The present retrospective study recruited patients admitted to King Abdulaziz University Hospital during 2018. We reviewed electronic records to collect data on essential demographics including age, gender, and nationality; history of prior CNS disease or related symptoms; results of neurological physical examination; and findings of radiological investigations such as abdominal ultrasound, dimercaptosuccinic acid scan, micturating cystourethrogram, diethylene triamine pentaacetic acid scan, brain computed tomography, and magnetic resonance imaging. The most commonly diagnosed renal pathologies were neurogenic bladder and cystic kidney disease. The most common neurological manifestation was seizure disorder. Males were more frequently affected with neurological sequelae than females. The prevalence of neurological disorders was higher in patients over two years old. The most frequently observed stage of chronic kidney disease was stage 5. Most children who were affected with a neurological disorder required hemodialysis as part of their management plan. Patients with chronic kidney disease are at a high risk of neurocognitive defects. The type of management and renal diagnosis are significant factors that should be considered when anticipating central nervous system involvement in the case of chronic kidney disease.

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Objectives Previous studies have not addressed microalbuminuria in pediatric patients with sickle cell disease (SCD) in Jeddah, Saudi Arabia. This study aimed to determine the prevalence of microalbuminuria and identify associated risk factors in children with SCD at King Abdulaziz University Hospital.Results Overall, 42.5% of the patients enrolled were Saudi Arabian and 51% were male. The patients’ mean age was 12.4 years, and the highest percentage (40%) was in the age group of 15–18 years. The prevalence of microalbuminuria was 9.6%, and hematuria was present in 8% of cases. The percentage of patients with hematuria was significantly higher in the microalbuminuria group (22.6%) than in the non-microalbuminuria group (6.5%; P=.007). The percentage of patients with acute chest syndrome was also higher in the microalbuminuria group (26%) than in the non-microalbuminuria group (8%; P=0.005). The percentage of patients with gallbladder stones was higher in the microalbuminuria group (13%) than in the non-microalbuminuria group (2.4%; P=.014). However, the mean number of blood transfusions was higher in the non-microalbuminuria group than in the microalbuminuria group (P=.002). Sickle cell nephropathy manifests as microalbuminuria, begins at an early age, occurs in all types of SCD, and is associated with disease severity.